Sickness and Stoicism

Sickness and Stoicism

Roy Wayne Meredith III
Roy Wayne Meredith III
6 min read

In less than three months, COVID-19 has changed from a peripheral concern, barely registering in presidential debates, to the greatest global crisis since World War II. We are living in extraordinary times, and there is scarcely an industry or country that has escaped the impact of the new virus. In the United States, the Federal Reserve estimates that the unemployment rate could briefly skyrocket to 32 percent—higher than anything the country experienced during the Great Depression. People have lost their livelihoods. Many others are scared about what is to come when they develop a fever or cough.

Illness, financial hardship, and loneliness are, nevertheless, well-trodden paths. One man who can guide us along the way is Seneca the Younger, a Roman philosopher and statesman and contemporary of Jesus. Seneca suffered from asthma, and his condition sometimes left him bedridden and gasping for air. As he grew older, he even contemplated suicide because his affliction was so severe. Seneca’s lifelong illness, as well as his background in Stoic philosophy, gave him the insight he needed to find dignity and joy in periods of extended hardship. “There are times,” he once wrote, “when even to live is an act of bravery.”

You don’t have to test positive for COVID-19 to appreciate the consolation offered by Seneca’s wisdom. Pandemics are multitiered crises—the virus itself is only one among many serious disruptions in our lives. Maybe you lost your job after the economy in your country fell into a coma. Or perhaps you’ve recently been diagnosed with diabetes and you’re worried about how the virus might aggravate it. You may also be unsure how to endure physical isolation in the months ahead, even though you already know that several months of suppression and social distancing is vital if the spread of this highly infectious disease is to be contained. Seneca, who was once exiled to Corsica by Emperor Claudius, would have a word or two to say about separation from friends and family.

The starting point is to have compassion for ourselves. We are not, after all, in complete control of our initial reactions to a diagnosis or an unexpected layoff. As Seneca writes in his 11th letter to Lucilius:

When they face a crowd of people some men, even ones with the stoutest of hearts, break into a sort of sweat one usually sees on persons in an overheated or exhausted state; some men experience a trembling at the knees when they are about to speak; some a chattering of the teeth, a stuttering tongue or stammering lips. These are things which neither training nor experience ever eliminates. Nature just wields her power and uses the particular weakness to make even the strongest conscious of her.

Here, Seneca is meditating upon the terror induced by public speaking. Nevertheless, his lesson about humility before nature is broadly applicable. The true test of resilience lies in how we cope with our subordination.

It helps to clarify our thinking and identify threats. In his 78th letter to Lucilius, who at the time was fighting his own battle with asthma, Seneca lists the three most common fears that attack us during illness: “dying, the physical suffering, and the interruption of our pleasures.” With characteristic bluntness, he argues that to dread an illness because it might kill you is irrational. “You will not die because you are sick, but because you are alive,” he points out. “That end still awaits you when you have been cured. In getting well again you may be escaping some ill health but not death.” Seneca’s point is not that life is unimportant, nor that we should be indifferent to medical advice. Rather, he is warning that fear of the inevitable only compounds our suffering, because “in illness, the suffering is always bearable so long as you refuse to be affected by the ultimate threat.”

Prolonged anxiety is a petri dish for all sorts of poor health outcomes, including, ironically, an elevated susceptibility to infectious diseases. Seneca placed supreme importance on managing anxiety by occasionally running through the worst-case scenarios in our minds, instructing Lucilius to “always take full note of fortune’s habit of behaving just as she pleases, treating her as if she were actually going to do everything it is in her power to do so.” Confronting what scares us in a safe environment is, of course, an established technique in cognitive behavioral therapy. Seneca’s peers called this practice premeditio malorum, and there are simple guides to begin applying it immediately to our own situations. After doing this, “whatever you have been expecting for some time comes as less of a shock,” Seneca promises his friend.

Fear of mortality isn’t only bad for the individual concerned. It also creates problems for others.  Just a few days ago, a doctor from Farmington sounded the alarm about a large influx of New Yorkers fleeing their state to wait out the pandemic in Maine. In other words, people almost certainly already exposed to COVID-19 were so scared of the virus that they risked infecting the population of another state to find sanctuary. It is hard to imagine a more destructive and short-sighted response, although the frightened individuals who hoard cleaning supplies at supermarkets are doing their best.

The second disruption Seneca identifies is physical suffering. He concedes that pain is a part of illness, but he promises Lucilius a more bearable experience if he separates the sensation itself from exaggerated perceptions of it:

Provided that one’s thinking has not been adding anything to it, pain is a trivial sort of thing. If by contrast you start giving yourself encouragement, saying to yourself, “it’s nothing—or nothing much, anyway—let’s stick it out, it’ll be over presently,” then in thinking it is a trivial matter you will be ensuring that it actually is. Everything hangs on one’s thinking. The love of power or money or luxurious living are not the only things guided by popular thinking. We take our cue from people’s thinking even in the way we feel pain.

Seneca encourages Lucilius to fortify himself by thinking of famous individuals who have dealt with worse. “This is a time for recollecting all those individuals of exceptional courage who have triumphed over pain,” he writes. Identifying role models is an important practice in Stoicism, because they inspire us and are benchmarks for measuring our own behavior. In this case, they also can provide us with perspective, which in turn shapes how we experience our own suffering.

Literal pain, of course, isn’t the only way that diseases can debilitate our bodies. We can also lose the ability to sleep, to walk, or in the most extreme cases of COVID-19, to even breathe without assistance. These set objective limits to what we can accomplish while we are ill. Seneca’s answer is to shift our priorities. Or, as the modern Stoic author Massimo Pigliucci puts it, “we need to focus on abilities, not disabilities.” In one deeply moving passage, Seneca writes:

[I]f you meet sickness in a sensible matter, do you really think you have accomplished nothing? You will be demonstrating that even if one cannot always beat it one can always bear an illness. There is room for heroism, I assure you, in bed as anywhere else. War and the battlefront are not the only spheres in which proof is to be had of a spirited and fearless character: a person’s bravery is no less evident under the bedclothes.

The final disruption that Seneca acknowledges is “the interruption of our pleasures.” We’re all familiar with this, especially if we live in a state or a country that has imposed a stay-at-home order. Acting on the best advice of epidemiologists and physicians, multiple governments have shut down cinemas, weddings, bonfires, beaches, and all other non-essential businesses. These shutdowns are literally saving lives.

Still, all these interruptions working in tandem are potentially very stressful. Seneca argues that eventually, we’ll stop craving what we used to desire. “And there is nothing harsh about having to do without things for which you have ceased to have any craving,” he concludes. (What Seneca is describing is called hedonic adaptation, a well-attested phenomenon in human psychology.) Even with modern technology, however, physical isolation from family and friends is deeply unpleasant. Not to be deterred, Seneca asks us to reflect on the unique advantages of physical distance in another letter to his friend:

There’s nothing to stop you from enjoying the company of absent friends, as often as you like, too, and for as long as you like. This pleasure in their company—and there’s no greater pleasure—is one we enjoy the more when we’re absent from one another… Possession of a friend should be with the spirit: the spirit’s never absent. It sees daily whoever it likes. So share with me my studies, my meals, my walks. Life would be restricted indeed if there were any barrier to our imaginations, I see you, my dear Lucilius. I hear you at this very moment. I feel so very much with you at this moment that I wonder whether I shouldn’t start writing you notes rather than letters!

Throughout both his life and his writing, Seneca showed that everyone has the strength to act heroically—even if it means doing something as simple as staying glued to your couch. And if indeed “everything hangs on one’s thinking,” as he and his philosophical heirs frequently remind us, then this pandemic is just as much an opportunity as it is a curse. We can all show our descendants that we were the generation who stopped everything to protect our society’s most vulnerable.

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